OBJECTIVE: To investigate the classification, structure and inducing drug resistance of integron in 59 strains of cefoxitin-resistant Escherichia coli. METHODS: PCR method was used to detect integrase gene (intI) and product of variable region of positive strain was performed on sequencing. Sensitiveness of experimental strains to 22 kinds of antibiotics was detected with microdilution method. RESULTS: IntI1 was identified in 45 strains (76%) of the 59 strains Escherichia coli. The most drug resistance genes cassettes were aadA5 and dfr17,only 2 strains encoding ?-lactamase drug resistance gene cassettes. The MIC of integron positive groups was statistically significantly higher than negative groups. CONCLUSION: Class 1 integron resided in cefoxitin-resistant Escherichia coli widely. The cause of drug resistance of integron positive strain to aminoglycosides, sulfonamides and chloramphenicol is drug resistance gene cassettes. Gene cassettes does not play important role in integron-mediated drug resistance.

OBJECTIVE:To investigate the classification,structure and integron-mediated AmpC enzyme gene transfer of integron in 25 strains of AmpC enzymeproducing Escherichia coli. METHODS:Sensitivity of test strains to 20 kinds of antibiotics was tested by microdilution method. PCR and sequencing were performed on test strains to identify integrase gene(intI)and its location,the product of variable region of positive integrons(Int)respectively. RESULTS:Class ⅠintI were indentified in 20 strains (80%)of 25 strains Escherichia coli. The most drug resistance box cassettes were aadA5 and dfr17 and integory encoding AmpC gene cassette was not observed. CONCLUSION:Class Ⅰ integron resided in AmpC enzyme-producing Escherichia coli widely. The cause of drug resistance of integorn to aminoglycosides,sulfonamides,chloramphenicol is drug resistance gene cassette. Gene cassette does not play important role in integron-mediated antibiotic resistant gene transformation.

OBJECTIVE:To investigate the effect of outer membrane protein on drug resistance of 59 strains of cefoxitin-resistant Escherichia coli.METHODS:PCR method was performed on test strains to identify OmpF gene.The outer membrane protein(OMP) profiles were studied by sodium dodecyl sulphate polyacrylamide gel electrophoresis(SDS-PAGE).Sensitivity of 20 kinds of antibiotics to test strains was tested by Microdilution.RESULTS:Among 59 strains of Escherichia coli,OmpF gene were positive in 29 strains(49%),of which 20 strains were among 25 strains which produced AmpC enzyme.30 OmpF gene-negative strains had not occurred OmpF protein bands,of which 13 strains missed OmpC protein bands simultaneously.Among 29 strains of OmpF gene-positive bacteria,4 stains missed OmpF protein bands.59 strains were all resistant to many types of antibiotics.CONCLUSION:Deletion of OmpF gene and protein is the main reason for non-AmpC enzyme production strains resistant to cefoxitin.Porin loss bring about primarily cefoxitin-resistant property but little impact on other antibiotics.

Objective To study the location of mycobacterium tuberculosis(MTB) and whether the cellular immunity is induced after immunization of H37Ra in mice.Methods Totally 72 BALB/C mice were included.Thirty mice were intracutaneously injected of 0.1 ml H37Ra solution(about 10~(6) bacteria) at caudal region;thirty mice were injected of BCG of same quantity instead;twelve were free from immunization as control.Viable MTB were detected in spleen and lungs on day 15,30 and 60 after intracutaneous vaccination of H37Ra.The proliferation of T lymphocytes stimulated with purified protein derivative(PPD) was measured by MTT assay and the production of interleukin-2(IL-2) and soluble interleukin-2 receptor(sIL-2R) in the cultural supernatants of T lymphocytes was also determined by ELISA on day 30 and 60 after intracutaneous vaccination of H37Ra.Results Viable H37Ra or BCG could be located in the spleen and lungs in mice for at least 60 d.After H37Ra immunization,the stimulation index(SI) of T lymphocyte proliferation on day 30 and 60 was(2.81?0.63),(2.16?0.52) respectively,which was of no significant difference with that of BCG immunization,but of significant difference with that of non-immunized mice(P

OBJECTIVE:To observe the efficacy and safety of domestic cefepime in the treatment of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) complicated with respiratory failure. METHODS:A total of ninety-six patients with AECOPD complicated with respiratory failure were randomly assigned to receive cefepime 2.0 g bid iv gtt (Group A,n=48) or cefoperazone/sulbactam (Group B,n=48) at a dose of 2.0 g bid iv gtt for 7～14 day. RESULTS:The effective rate was 82% for Group A versus 62% for Group B(P0.05). CONCLUSION:The efficacy of cefepime is higher than that of cefoperazone/sulbactam in the treatment of patients with AECOPD complicated with respiratory failure,but both had good safety.

OBJECTIVE:To evaluate the cough-relieving and sputum-eliminating efficacy and safety of Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution.METHODS:By a randomized control study,a total of 60 patients characterized by nonproductive cough andlittle sputum were randomly assigned to receive Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution(Trial Group)or Ambroxol Hydrochloride Oral Solution(Control Group)l0 mL tid for 5～7 d.RESULTS:Both groups had a significant improvement in symptoms including cough and expectoration after treatment(P0.05).CONCLUSION:Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution is more effective in relieving cough than Ambroxol Oral Solution,and it has certain effect in eliminating phlegm.In addition,it is safe and has little adverse reaction.

OBJECTIVE:To observe clinical efficacy and safety of levofloxacin and azithromycin in the treatment of community acquired mycoplasma pneumonia (CAMP).METHODS:A total of 108 patients with CAMP were randomly divided into group A and group B (n=54).Group A received intravenous administration of levofloxacin (0.6 g,qd) and group B intravenous administration of azithromycinin (0.5 g,qd) for 7 days.The clinical efficacy and ADR of 2 groups were observed.RESULTS:The total effective rates of group A and group B were 83% and 56%,there was significant difference between 2 groups (P0.05).CONCLUSION:The clinical efficacy of levofloxacin in the treatment for CAMP is better than that of azithromycin.Levofloxacin and azithromycin have good safety.

Objective To investigate the application effects of ultrasonic scalpel combined with bipolar coag-ulation tweezers on open thyroid surgery.Methods 80 cases of thyroidectomy patients were randomly selected.These patients were divided into two groups by random cluster sampling method,whch were the study group (n =40)and control group (n =40).The control group of patients were given ultracision ligature methods combined with traditional therapy,while the study group of patients were given ultrasonic scalpel combined with bipolar coagulation tweezers treatment.And then the surgical related indicators and complications of the two groups of patients were statistically an-alyzed.Results Compared with the control group of (90.5 ±3.6)min,(6.5 ±0.6)d,(40.5 ±2.0)mL,(50.3 ± 1.4)mL and (6.6 ±0.5)cm,the operative time and length of stay of the study group of patients[(58.5 ±5.4)min and (3.4 ±0.2)d]were significantly shorter (t =6.965,3.143,all P <0.05);the blood loss and postoperative drainage of (5.0 ±1.4)mL and (1.0 ±0.6)mL were significantly less (t =4.541,3.747,all P <0.05);the cut diameter of (3.8 ±0.3)cm was significantly shorter (t =3.365,P <0.05);the complication rate of 2.5% (1 /40) was significantly lower than the control group 10.0%(4 /40)(χ2 =9.35,P <0.05).Conclusion The application effects of ultrasonic scalpel combined with bipolar coagulation tweezers on open thyroid surgery are obvious.

OBJECTIVE:To evaluate the efficacy and safety of the application of airway secretions expurgation cluster manage-ment in oxygen-driven aerosol inhalation. METHODS:280 patients with chronic obstructive pulmonary disease in the Respiratory Second Division of our hospital from Mar. 2012 to Dec. 2013 were randomly divided into group A,B,C and D,with 70 cases in each group.Group A and B were treated with compound isopropyl bromide 2 ml+nomal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalation for 7 days;group C and Dreceived Ambroxol hydrochloride injection 15 ml+normal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalatiom for 7 days. group A and C were treatment groups, group B and D were control groups. Two treatment groups inhaled compound medications while the application of airway secretions expurgation cluster management. Two control groups inhaled compound medications with single effective cough guidance. RE-SULTS:Compared with control groups,the patients in treatment groups eliminated more phlegm,had lower (PaCO2)and higher (PaO2),also had a shorter hospitalization period,with significant difference(P<0.05). CONCLUSIONS:Airway secretions expur-gation cluster management technology is a simple,safe and effective method,especially in patients with chronic obstructive pulmo-nary disease in oxygen-driven inhalation therapy.

There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.